双嘧达莫辅助治疗川崎病患儿的疗效及对抗血小板聚集相关因子免疫功能 CRP及PCT水平的影响

doi:10.3969/j.issn.1006-6233.2021.10.031

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摘要 目的:观察双嘧达莫佐治川崎病(KD)的疗效,及对抗血小板聚集相关因子、免疫功能、血清C反应蛋白(CRP)、降钙素原(PCT)的影响。方法:前瞻性地选取2019年2月至2021年2月我院收治的68例KD患儿作为研究对象,以随机数字表简单随机分成两组,每组34例,对照组为常规治疗,观察组结合双嘧达莫治疗。比较临床指标、抗血小板聚集相关因子[血小板计数(PLT)、白细胞计数(WBC)及红细胞沉降率(ESR)]、血清CRP、PCT水平,及免疫功能指标(CD3⁺、CD4⁺、CD8⁺及IgA、IgG、IgM)。结果:观察组患儿发热、黏膜充血、四肢肿胀、淋巴结肿大等症状消退时间及住院时间均显著低于对照组患儿(P<0.05);观察组患儿冠状动脉损伤(CAL)发生率为14.71%,显著低于对照组患儿的38.24%(P<0.05)。两组患儿治疗后血PLT、WBC、ESR、CRP、PCT均显著低于治疗前(P<0.05);治疗后观察组患儿血PLT、WBC、ESR、CRP、PCT显著低于对照组患儿(P<0.05);观察组患儿血PLT、WBC、ESR、CRP、PCT治疗前后差值均高于对照组(P<0.05)。两组患儿治疗后CD4⁺显著低于治疗前(P<0.05),CD8⁺、IgA、IgG显著高于治疗前(P<0.05);治疗后观察组患儿CD4⁺显著低于对照组患儿(P<0.05),CD8⁺、IgA、IgG显著高于对照组患儿(P<0.05);观察组患儿CD3⁺、CD4⁺、CD8⁺、IgA、IgG、IgM治疗前后差值均高于对照组(P<0.05)。两组患儿不良反应总发生率比较差异无统计学意义(P>0.05)。结论:双嘧达莫可提高KD患儿抗血小板聚集能力、提升免疫功能及降低血清CRP、PCT水平,最终达到促进患儿康复效率并减少CAL发生率的效果。

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	王凤娟
	邢雅明

关键词 ：川崎病, 双嘧达莫, 阿司匹林, 丙种球蛋白, 抗血小板聚集, 免疫功能

Abstract：Objective: To observe the efficacy of dipyridamole in treating KD, and its effects on platelet related parameters, immune function, serum CRP and PCT. Methods: 68 children with KD admitted to our hospital from February 2019 to February 2021 were prospectively selected as the study subjects. All the children were divided into 2 groups with 34 cases in each group by simple numerical random table method. The control group underwent conventional treatment, and the observation group underwent dipyridamole. Clinical indexes, platelet-related parameters (PLT, WBC, ESR), serum CRP, PCT levels, and immune function indexes (CD3⁺, CD4⁺, CD8⁺, IgA, IgG, IgM) were compared. Results: The subside time of fever, mucosal congestion, limb swelling, lymph node enlargement symptoms and the length of hospital stay in the observation group were significantly lower than those in the control group (P<0.05). The incidence of CAL in the observation group was 14.71%, which was significantly lower than 38.24% in the control group (P<0.05). After treatment, blood PLT, WBC, ESR, CRP and PCT in 2 groups were significantly lower than those before treatment (P<0.05). After treatment, blood PLT, WBC, ESR, CRP and PCT in observation group were significantly lower than those in control group (P<0.05). The differences of blood PLT, WBC, ESR, CRP and PCT in observation group were higher than those in control group before and after treatment (P<0.05). After treatment, CD4⁺ was significantly lower than before treatment (P<0.05), while CD8⁺, IgA and IgG were significantly higher than before treatment (P<0.05). After treatment, CD4⁺ in observation group was significantly lower than that in control group (P<0.05), and CD8⁺, IgA and IgG in observation group were significantly higher than those in control group (P<0.05). The differences of CD3⁺, CD4⁺, CD8⁺, IgA, IgG, IgM in the observation group were higher than those in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Dipyridamole can improve anti-platelet aggregation ability, enhance immune function, and reduce serum CRP and PCT levels in children with KD, finally it achievs the effect of promoting rehabilitation efficiency and reduces the incidence of CAL.

Key words： KD Dipyridamole Aspirin Gamma globulin Anti-platelet aggregation Immune function

基金资助:辽宁省科学技术计划项目,(编号:20190540928)

引用本文:

王凤娟, 邢雅明. 双嘧达莫辅助治疗川崎病患儿的疗效及对抗血小板聚集相关因子免疫功能 CRP及PCT水平的影响[J]. 河北医学, 2021, 27(10): 1724-1728.
WANG Fengjuan, XING Yaming. Effects of Dipyridamole Adjuvant Therapy on Platelet-Related Parameters Immune Function, CRP and PCT Levels in Children with KD. HeBei Med, 2021, 27(10): 1724-1728.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.10.031 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I10/1724

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